Aaron Court Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence the provider met people’s needs. At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate. This meant services were not planned or delivered in ways that met people’s needs. The provider was in breach of legal regulation in relation to person centred care.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not consistently ensure people were at the centre of their care and treatment choices or work in partnership with people to respond to changes in their needs. Person-centred care was not consistently embedded in everyday practice. We saw some people had limited personal interaction, reassurance or meaningful engagement. Some people told us they felt lonely or bored. Staff contact was at times focused on completing care tasks rather than spending time talking or engaging with people. Some people were left sitting with televisions turned down and activity materials nearby but not being used. People were not always supported to eat and drink in ways that reflected their personal preferences or daily routines. While some people’s care records included personal details, many were generic or based on templates. Preferences were not consistently translated into clear, practical guidance for staff, and reviews often repeated the same wording without demonstrating meaningful change. Some professional partners raised concerns about person-centred planning, particularly in relation to continence, nutrition, hydration, pressure care and medicines. They reported delays in updating support levels, gaps in referrals and limited use of behaviour support plans. Some relatives said people had limited choice, activities were not always suitable, or people attended sessions without being meaningfully involved. One person told us, “I help out with the activities, but they could do with more choices.” We observed some examples of positive, person-centred interactions. Some staff engaged well with people, offering choice, explaining care and supporting meaningful activity. Some people spoke positively about social activities. One person said, “We do bingo, and we have such a laugh. Everyone joins in.” Staff we spoke with recognised further improvement was needed, particularly in relation to mealtimes and meaningful engagement.

There were shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity. Care was not consistently well coordinated or integrated with wider health, care and advocacy services. People did not always receive joined up support that promoted choice, continuity or equitable access to the care they needed. Continuity of care often relied on individual staff members knowing people well, rather than on robust systems such as clear care plans, accurate records, effective communication across shifts and a consistent staff team. Care records frequently contained unclear, generic or conflicting information. For example, one person with complex physical needs had contradictory instructions across different care plans, and the guidance lacked the necessary detail about staffing support or specialist equipment required. Support varied across different areas of the home and between shifts, which meant people did not always experience consistent, reliable care. Although some staff described positive steps such as improved handovers and short meetings to share updates, these improvements were not well embedded across the service. Frequent changes in management meant that best practice was not consistently implemented, including ensuring people had appropriate access to advocacy and external healthcare services.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. They did not have a consistent and reliable way of providing people and relatives with clear information. This left some people and relatives unsure about what was happening and reduced confidence that concerns and changes in care were being properly understood and followed up. Communication from the provider was inconsistent and often depended on informal conversations rather than a clear, reliable approach. Leaders told us formal ways of sharing information, such as surveys and written updates, did not always work well. Some relatives said they were not kept informed after incidents or changes in care and had to repeatedly chase the provider for updates. One relative said, “We always have to prompt them.” Several relatives told us communication improved when the provider was under external scrutiny, rather than it being part of everyday practice.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. Some people felt listened to in everyday conversations. However, formal involvement in care planning, reviews and service improvement was underdeveloped. Most people we spoke with told us they were not aware of being involved in care reviews or planning. When asked about reviews, comments included, “No, I don’t think I have them,” and “Not that I know.” Records we viewed did not evidence people had been involved in developing their care plans. Some relatives said their concerns were not listened to. Comments included, “No, not at all,” and “Not really.” Several relatives described involvement as inconsistent and reactive. They said responsiveness improved mainly during times of external scrutiny and they were not routinely asked for feedback or involved in shaping improvements. Multiple relatives said they were only contacted after a “bad [CQC] report.” Others described staff as open and approachable, saying there was an “open door.” Some relatives gave examples where feedback led to action, such as a bedroom door being kept closed after concerns about people entering rooms. We shared our findings with leaders who described steps they were taking to improve involvement, including arranging relatives’ meetings, using questionnaires in reception, and increasing communication by email.

The provider did not consistently ensure people could access the care, support and treatment they needed when they needed it. Access to staff support and meaningful activities varied depending on staffing levels, staff familiarity and how care was organised, rather than a consistently planned and equitable approach. Reasonable adjustments for people who could not independently request help were not always applied, increasing the risk their needs were not identified or responded to promptly. During visits across different times of day, we observed occasions where people experienced delays in receiving support. We saw quieter people, or those who found communication difficult, were not always proactively supported to engage in activities or request assistance. We identified gaps in some people’s records and limited evidence of a consistently planned, needs-led approach to ensuring equitable access to care and support. Several relatives told us permanent staff were more responsive and knowledgeable about people’s needs than agency or newer staff. Some relatives described delays in accessing support at night. Some staff told us access to activities and external services could vary depending on staffing levels and how busy the shift was.

Staff and leaders did not consistently use information about people most at risk of inequality to tailor care. The provider lacked effective systems to identify, monitor and reduce potential differences in people’s experiences and outcomes. Documentation showed gaps in assessment and monitoring, particularly for people who required support to express their needs. Care was not consistently delivered in a way that ensured all people’s needs were identified and responded to in a timely and equitable manner. Some people’s care plans did not record or act on protected characteristics or communication needs. Where concerns such as weight loss or new wounds were identified, we did not always see timely review or follow-up. Some relatives reported concerns including weight loss, dehydration, pressure-related skin damage and unexplained injuries. Others reported improvements for some people since the last assessment. Professional partners noted progress for some individuals but ongoing inconsistency in monitoring and follow-through. They told us outcomes could vary depending on staffing continuity and skill mix, particularly at night and weekends.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Planning for the future was not consistent, reliable or proactive. The provider did not consistently prepare for changes in people’s health or preferences. Care plans frequently used general wording and did not show clear forward planning. Staff were not always guided on what should change or what extra support should be put in place to prevent further problems. There was limited evidence people were supported to record or review their future wishes while they still had the ability to do so. Staff could not consistently explain how these needs were identified or passed on when people’s health declined. Some staff said review processes had improved, but they pointed out gaps in clear guidance and forward planning, particularly about what to do when people’s needs changed. We shared our findings with leaders who described new systems they were putting in place to improve future planning. However, these were not yet part of everyday practice across the service.